The managed competition approach to health care reform relies, in part, on consumer choice to improve the performance of health care markets and health care delivery systems. Under managed competition, mechanisms will be set up to monitor plans and disseminate quality of care and plan performance information to the public. The assumption is that consumers will make choices based on this newly available information, and the collective effect of these informed choices will influence providers to improve medical practice. However, existing quality of care indicators have not been particularly accessible, consumer-oriented, or "user- friendly." How do consumers understand quality of care information? Do they view it as relevant for making choices? The promise of Health Care Reform is to provide coverage to millions of Americans who currently have inadequate or no health insurance. These newly protected consumers will have less experience and skill in discriminating among plan choices and in interpreting the available plan and provider quality indicators than those whose insurance has given them more access. The proposed study utilizes a focus group methodology and content analysis to examine the degree to which consumers understand managed care, understand quality of care indicators, and the extent to which they find these indicators useful for making health care choices. Further, because of the large population of uninsured who will be newly covered under health care reform, the study examines differences between the insured and the uninsured in their comprehension of managed care concepts and quality of care indicators and perceived salience of indicators. The proposed project is a first step, a pilot, for building the foundation for other studies. One product of this study will be a developed and pre- tested telephone survey instrument: "The Health Care Consumer Knowledge Sur y". The findings from this investigation will be important to the effective implementation of managed competition. The results can inform the process of information dissemination to assure that quality indicators are accessible and useful for consumers. Further, the findings may inform the development of larger educational efforts for assisting consumers, including newly insured consumers, in this transition to managed competition.